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STEP 1 (4) > Parasites > Flashcards

Parasites Flashcards

1
Q

What are the main protozoa causes of GI infection?

A

Giardia lamblia

Entamoeba histolytica

Cryptosporidium

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2
Q

How does Giardiasis present?

A

bloating, flautlence, foul-smelling fatty diarrhea (often seen in campers and hikers) and is transmitted via cysts in contaminated water

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3
Q

How is Giardiasis tx?

A

metronidazole

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4
Q

How is Giardiasis diagnosed?

A

Trophozoites or cysts in stool

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5
Q

Entamoeba histolytics is the cause of _______

A

Amebiasis

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6
Q

How does Amebiasis present?

A

bloody diarrhea (dysenery), liver abscess (anchovy oasta exudates), RUQ pain, and histology showing a flask-shaped ulcer

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7
Q

How is Ambeiasis contracted?

A

cysts in water

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8
Q

How is Amebiasis diagnosed?

A

Serology and/or trophozoites (With RBCs in the cytoplasm) or cysts (with up to 4 nuclei) in stool

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9
Q

How is Amebiasis tx?

A

Metronidazole

iodoquinol for asymptomatic cyst passers

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10
Q

What parasite is known to cause severe diarrhea in AIDs pts and mild disease (watery diarrhea) in immunocompetent hosts?

A

Cryptosporidium

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11
Q

How is Cryptosporidium diagnosed?

A

oocysts on acid-fast stain

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12
Q

How is Cryptosporidium tx?

A

prevention by filtering water supplies and nitazoxanide in immunocompetent hosts

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13
Q

What protozoa cause CNS infection?

A

Toxoplasma gondii

Naegleria fowleri

Trypanosoma brucei

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14
Q

What disease does Toxoplasma gondii cause?

A

1) Congenital toxoplasmosis with a classic triad of chorioretinitis (below), hydrocephalus, and intracranial calcifications
2) Reactivation in AIDs- ring enhancing lesions on CT/MRI

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15
Q

Reactivation of Toxo in AIDs- ring enhancing lesions on CT/MRI

A
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16
Q

How is toxo transmitted?

A

cysts in meat (most common); occysts in cat feces

crosses the placenta (pregnant women should avoid cats)

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17
Q

How is toxo diagnosed?

A

Serology

or biopsy showing tachyzoites or bradyziotes

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18
Q

How is toxo tx?

A

Sulfadiazine and pyrimethamine

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19
Q

What disease does Naegleria fowleri cause?

A

Rapdily fatal meningoencephalitis

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20
Q

How is Naegleria fowleri transmitted?

A

swimming in freshwater and enters via the cribriform plate

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21
Q

How is Naegleria fowleri tx?

A

Ampho B (will likely die though)

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22
Q

What parasite causes African Sleeping sickness?

A

Trypanosoma brucei

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23
Q

How does African Sleeping sickness present?

A

enlarged lymph nodes, recurring fever due to antigenic variation, somnolence, and coma

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24
Q

What is the reservoir of Trypanosoma brucei?

A

tsetse fly, a painful bite

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25
Q

How is Trypanosoma brucei diagnosed?

A

blood smear

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26
Q

How is African sleeping sickness tx?

A

Suramin for blood borne disease or melarsporol for CNS penetration

melatonin for sleep

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27
Q

What protozoa cause hematologic infections?

A

Plasmodium (P. viva.ovale, falcoparum, and malariae)

Babesia

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28
Q

Plasmodium is the cause of ______

A

Malaria

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29
Q

What are the primary symptoms of malaria?

A

fever, HA, anemia, and splenomegaly

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30
Q

What is the vector for Plasmodium?

A

Anopheles mosquito

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31
Q

How does P. vivax/ovale induced malaria present?

A

48 hr cycle (tertain; includes fever on first day and third dayl thus fevers are actually 48 hrs apart); dormant form (hypnozoite) in liver

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32
Q

How does P. falciparum induced malaria present?

A

severe; irregular fever pattern, parasitized RBCs occlude brain capillaries (cerebral malaria), kidneys, and lung

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33
Q

How does P. malariae induced malaria present?

A

72 hr cycle (quartan)

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34
Q

How is malaria diagnosed?

A

blood smear- trophzoite ring form within RBC (below)

Schizont containing merozoites

red granules (Schuffner stippling) throughout RBC cytoplasm seen with P. vivax/ovale

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35
Q

Malaria- Schizont containing merozoites

A
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36
Q

How is malaria tx?

A

Chloroquine for sensitive species (blocks Plsmodium heme polymerase)

If resistant, use mefloquine or atovaquone/proguanol

If life threatening, use IV quindine or artesunate (test for G6PD deficiency)

For P. vivax.ovale, add primaquine for hyponozoite (test for G6PD deficiency)

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37
Q

Babesia causes Babesiosis. How does this present?

A

fever and hemolytic anemia, predominantly i the northEASTERN US (asplenia increases the risk for disease)

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38
Q

What carriers Babesia?

A

Ixodes tick (same as Lyme disease- may often coinfect)

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39
Q

How is Babesia diagnosed?

A

blood smear (ring form or Maltese cross)

PCR

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40
Q

How is Babesia tx?

A

Atovaquone and azithromycin

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41
Q

What protozoa cause visceral infections?

A

Trypanosoma cruzi

Leishmania donovani

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42
Q

What disease does Trypanosoma cruzi cause?

A

Chagas disease

43
Q

How does Chagas disease present?

A

dilated cardiomyopathy with apical atrophy

megacolon

megaesophagus

Romana sign- unilateral periorbital swelling (below)

mostly in South America

44
Q

What transmits Trypanosoma cruzi?

A

reduviid bug (aka the kissing bug) which deposits it the parasite in feces or via a painless bite (like a kiss)

45
Q

How is Chagas disease diagnosed?

A

Blood smear

47
Q

How is Chaga disease tx?

A

Benznidazole or nifurtimox

48
Q

What cause Visceral leishmaniasis?

A

Leishmania donovani

49
Q

How does Visceral leishmaniasis present?

A

spikin fevers, hepatosplenomegaly, pancytopenia

50
Q

What transmits Leischmania donovani?

51
Q

How is Leischmania donovani diagnosed?

A

Macrophages containg amastigotes

52
Q

How is Leishmania tx?

A

Ampho B or sodium stibogluconate

53
Q

What is the main sexually transmitted parasite?

A

Trichmonas vaginalis

54
Q

What disease does Trichmonas vaginalis cause?

A

vaginitis, marked by a foul-smelling, greenish discharge, itching and burning (dont confuse with Gardnerella vaginalis, a gram-variable bacterium associated with bacterial vaginosis)

NOTE: This must be transmitted sexually because it cannot exist outside humans, cannot form cysts

55
Q

How is vaginitis diagnosed?

A

Strawberry cervix

56
Q

Vaginitis. Tx?

A

Metronidazole for pt and partner

57
Q

What are the intestinal nematodes?

A

Enterbius vrmicularis (pinworm)

Ascaris lumbricoides (giant roundworm)

Strongyloides stercoralis

Ancylostoma duodenale, Necator americanus (hookworms)

Trichinella spiralis

58
Q

How is Enterbius vrmicularis (pinworm) transmitted?

A

fecal-oral

59
Q

How does Enterbius vrmicularis (pinworm) infection present?

A

intestinal infection causing anal pruritis, diagnosed by seeing eggs via a tape test

60
Q

How is Enterbius vermicularis tx?

A

Bendazoles (because worms are bendy)

61
Q

How is Ascaris lumbricoides transmitted and what disease does it cause?

A

fecal oral and causes an intestinal infection with possible obstruction of the ileocecal valve

62
Q

How is Ascaris lumbricoides diagnosed?

A

visualizing eggs in feces

Tx: Bendazoles

63
Q

How is Strongyloides stercoralis tx?

A

Larvae in the soil penetrate the skin

64
Q

What disease does Strongyloides stercoralis cause?

A

Intestinal infection causing vomiting, diarrhea, epigastric pain (may feel like a peptic ulcer)

65
Q

How is Strongyloides stercoralis tx?

A

Ivermectin or bendazoles

66
Q

How is Ancylostoma duodenale, Necator americanus (hookworms) transmitted?

A

Larvae penetrating skin

67
Q

What disease do Ancylostoma duodenale, Necator americanus (hookworms) cause?

A

intestinal infection causing ANEMIA by sucking blood from intestinal walls

68
Q

How are hookworms tx?

A

bendazoles or pyrantel pamoate

69
Q

How is Trichinella spiralis transmitted?

A

fecal- oral or undercooked meat (esp. pork)

70
Q

What disease does Trichinella spiralis cause?

A

Intestinal infection; larvae enter the bloodstream and encyst in striated muscle cells causing muscle inflammation

Trichinosis- fever, vomiting, nausea, periorbital edema, myalgia

It is sometimes referred to as the “pork worm” due to it being typically encountered in undercooked pork products.

71
Q

Trichinella species, the smallest nematode parasite of humans, have an unusual lifecycle, and are one of the most widespread and clinically important parasites in the world.[2] The small adult worms mature in the small intestine of a definitive host, such as a pig. Each adult female produces batches of live larvae, which bore through the intestinal wall, enter the blood (to feed on it) and lymphatic system, and are carried to striated muscle. Once in the muscle, they encyst, or become enclosed in a capsule. Humans can become infected by eating infected pork, horsemeat, or wild carnivores such as fox, cat, or bear

A

The first symptoms may appear between 12 hours and two days after ingestion of infected meat. The migration of adult worms in the intestinal epithelium can cause traumatic damage to the host tissue, and the waste products they excrete can provoke an immunological reaction. The resulting inflammation can cause symptoms such as nausea, vomiting, sweating, and diarrhea. Five to seven days after the appearance of these symptoms, facial edema and fever may occur. Ten days following ingestion, intense muscular pain, difficulty breathing, weakening of pulse and blood pressure, heart damage, and various nervous disorders may occur, eventually leading to death due to heart failure, respiratory complications, or kidney malfunction, all due to larval migration.

72
Q

What parasites infect tissue?

A

Onchocerca volvulus

Loa loa

Wuchereria bancrofti

Toxocara canis

73
Q

What is the carrier of Onchocerca volvulus?

A

female blackfly bite

74
Q

How does Onchocerca volvulus infection present?

A

Hyperpigmented skin and river blindness (black flies, black skin nodules, “black” sight); allergic rxn to microfilaria possible

75
Q

How is Onchocerca volvulus tx?

A

Ivermectin (for rIVER blindness)

76
Q

What is the carrier of loa loa?

A

Deer fly, horse fly, mango fly

77
Q

How does loa loa present?

A

worms in conjunctiva

swelling in skin

78
Q

How is Loa Loa tx?

A

Diethylcarbamazine

79
Q

What is the carrier of Wuchereria bancrofti?

A

Female mosquito

80
Q

What disease does Wuchereria bancrofti cause?

A

Elephantiasis- due to worms blocking lymphatics (takes 9 months to a year to become symptomatic after a bite)

81
Q

How is Wuchereria bancrofti tx?

A

Diethylcarbamazine

82
Q

Toxocara canis

A

Transmission: fecal-oral

Disease: visceral larva migrans

Tx: Bendazoles

83
Q

What nematodes cause disease via INGESTION?

A

Enterbius, Ascaris, Toxocara, Trichinella

Youll get sick if you EATT these

84
Q

What nematodes cause disease CUTANEOUSLY?

A

Strongyloides, Ancylostroma, Necator

85
Q

What nematodes cause disease via BITES?

A

Loa loa, Onchocerca volvulus, Wiuchereria bancrofti

86
Q

What are the cestodes (tapeworms)?

A

Taenia solium

Diphyllbothrium latum

Echincoccus granulosus

87
Q

Taenia solium can present two ways. Number 1.

A

Transmitted; Ingestion of larvae encysted in undercooked pork

Disease: intestinal infection

Tx: Praziquantel

88
Q

Taenia solium can present two ways. Number 2.

A

transmission: Ingestion of eggs

Disease: cysticercosis, neurocysticercosis

Tx: Praziquantel; albenazole for neurocysticerosis

89
Q

What is this?

A

neurocysticerosis via Taenia solium

90
Q

How is Diphyllobothrium latum transmitted?

A

ingestion of larvae from raw freshwater fish

91
Q

What disease does Diphyllobothrium latum cause?

A

vitB12 deficiency by competing for uptake (results in a megaloblastic anemia)

92
Q

How is Diphyllobothrium latum tx?

A

Praziquantel

93
Q

How is Echinococcus granulosus transmitted?

A

ingestion of eggs from dog feces

Sheep are an intermediate host

94
Q

What disease does Echinococcus granulosus cause?

A

Hydatid cysts in the liver (below) causing anaphylaxis if antigens are releases (thus these hydatid cysts are injected with ethanol or hypertonic saline to kill daughter cysts before removal)

95
Q

How is Echinococcus granulosus tx?

A

Albendazole

96
Q

What are the termatodes (flukes)?

A

Schistosoma

Clonorchis sinesis

97
Q

How is Schistosoma transmitted?

A

snails are the host and cercariae pentrate human skin

98
Q

What disease does Schistosoma cause?

A

Liver and spleen enlargement leading to fibrosis and inflammation

99
Q

Chronic infection with Schistosoma haemotobium can lead to what?

A

squamous cell carcinoma of the bladder (painless hematuria and pulmonary HTN)

100
Q

How is Schistosoma tx?

A

Praziquantel

101
Q

How is Clonorchis sinesis transmitted?

A

undercooked fish

102
Q

What disease does Clonorchis sinesis cause?

A

bilitary tract inflammation causing pigmented gallstones; associated with cholangiocarcinoma

103
Q

How is Clonorchis sinesis tx?

A

Praziquantel

STEP 1 (4) (18 decks)

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